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Quantitative assessment of subcortical atrophy and iron content in progressive supranuclear palsy and parkinsonian variant of multiple system atrophy

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An Erratum to this article was published on 21 February 2015

Abstract

It is a matter of debate whether increased brain iron levels are the cause or only the consequence of neurodegenerative process in degenerative parkinsonism. The aim of this study is to characterize disease-related changes in volumes and iron-related R2* values of basal ganglia and thalamus. 13 patients with progressive supranuclear palsy (PSP), 15 with a parkinsonian variant of multiple system atrophy (MSA-p), 29 with Parkinson’s disease (PD), and 21 age-matched controls underwent 3-Tesla MRI. The R2* values and volumes were calculated for the selected subcortical structures (caudate nucleus, putamen, globus pallidus, and thalamus) using an automated region-based analysis. Voxel-based analysis was also performed to visualize a topographical correlation of R2* value and volume. The PSP group had significantly higher R2* values in globus pallidus and caudate nucleus (p < 0.05), whereas the MSA-p group had higher R2* values in putamen (p < 0.001) than PD and controls. The globus pallidus in PSP and the putamen in MSA-p were the most significant areas of atrophy to differentiate PSP, MSA-p and PD (AUC = 0.856, 0.832, respectively, p < 0.001). The R2* values in both structures increased in parallel with the extent of atrophy. They were negatively correlated with volumes in putamen (r = −0.777, p < 0.001) and globus pallidus (r = −0.409, p = 0.025) of MSA-p, and globus pallidus (r = −0.4, p = 0.043) of PSP. Voxel-based analysis identified higher R2* values in more severely atrophic sub-regions in these structures. We observed topographical differences of iron deposition as well as atrophy between MSA-p and PSP. Increased iron levels were related to the structural atrophy in basal ganglia. Our results imply that iron accumulation is likely an epiphenomenon of the degenerative process.

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Acknowledgments

This study was supported by a grant from the Pusan National University Yangsan Hospital (2012).

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomo-ri, Mulgum-eup, Yangsan, Gyeongsangnam-do, 626-770, South Korea

    Jae-Hyeok Lee

  2. Department of Biomedical Engineering, Inje University, Gimhae, South Korea

    Yong-Hee Han, Bok-Man Kang & Chi-Woong Mun

  3. School of Korean Medicine, Pusan National University, Yangsan, South Korea

    Sang-Jae Lee

  4. Department of Diagnostic Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Seung-Kug Baik

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  1. Jae-Hyeok Lee
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Correspondence to Jae-Hyeok Lee.

Additional information

J.-H. Lee and Y.-H. Han contributed equally to this study as first authors.

An erratum to this article is available at http://dx.doi.org/10.1007/s00415-015-7670-2.

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Lee, JH., Han, YH., Kang, BM. et al. Quantitative assessment of subcortical atrophy and iron content in progressive supranuclear palsy and parkinsonian variant of multiple system atrophy. J Neurol 260, 2094–2101 (2013). https://doi.org/10.1007/s00415-013-6951-x

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  • DOI: https://doi.org/10.1007/s00415-013-6951-x

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